Anonymous
Post 01/02/2016 00:49     Subject: Confused about expressive speech delay
Anonymous wrote:Your kid doesn't have a delay. The SLO is trying to get your money. Those scores fall within avg range and there is not a huge discrepancy between rec and exp scores.

With that being said, what made you decide to get him tested?


As mentioned above, I had some concerns about articulation.
Anonymous
Post 01/02/2016 00:46     Subject: Confused about expressive speech delay
Your kid doesn't have a delay. The SLO is trying to get your money. Those scores fall within avg range and there is not a huge discrepancy between rec and exp scores.

With that being said, what made you decide to get him tested?
Anonymous
Post 01/01/2016 21:42     Subject: Confused about expressive speech delay
Anonymous wrote:OP, where are you located? You should be able to get a free audiological eval though DC or your state. If it's DC, you can contact early stages.


We are in Northern Virginia, Fairfax County.
Anonymous
Post 01/01/2016 21:39     Subject: Confused about expressive speech delay
OP, where are you located? You should be able to get a free audiological eval though DC or your state. If it's DC, you can contact early stages.
Anonymous
Post 01/01/2016 21:29     Subject: Re:Confused about expressive speech delay
Anonymous wrote:
Anonymous wrote:OP here. Thanks again for the thoughtful posts and useful input. I appreciate the suggestion to follow up with an audiologist. (DD did fail the test at a lower frequency for one of her years.)


I would really make an appt. ASAP. My son's articulation was off and he had similar language scores and we never realized he couldn't hear well. Luckily it was correctable with ear tube surgery. Google how to read an audiogram and look at the audiogram of familiar sounds.
Here is one example:
https://www.google.com/search?q=audiogram+of+familiar+sounds&ie=UTF-8&oe=UTF-8&hl=en&client=safari#imgrc=d2GBumAYAUKWgM%3A

His audiologist explained that kids really should hear at 15 decibels or better but pediatricians and schools often set their passing standards to 25 decibels. Whispering is at around 20 decibels. Once my son got ear tubes his speech and language skyrocketed. We also did the Wordly Wise program and read aloud a lot to him. He is now in 3rd grade and has a really good vocabulary. We notice that every once in a while he mispronounces a word and we think it is because he learned it when he was three and not hearing well. One ear still isn't as good as the other (pass at 25 decibels) so his audiologist wrote a note for him to be seated with better ear toward teacher and away from loud ambient noise like an air conditioning unit.


Many thanks, will do. (OP here) Do you happen to have a recommendation for audiologist? (I will call the pediatrician tomorrow and ask for his recommendations as well).
Anonymous
Post 01/01/2016 21:26     Subject: Re:Confused about expressive speech delay
Anonymous wrote:OP here. Thanks again for the thoughtful posts and useful input. I appreciate the suggestion to follow up with an audiologist. (DD did fail the test at a lower frequency for one of her years.)


I would really make an appt. ASAP. My son's articulation was off and he had similar language scores and we never realized he couldn't hear well. Luckily it was correctable with ear tube surgery. Google how to read an audiogram and look at the audiogram of familiar sounds.
Here is one example:
https://www.google.com/search?q=audiogram+of+familiar+sounds&ie=UTF-8&oe=UTF-8&hl=en&client=safari#imgrc=d2GBumAYAUKWgM%3A

His audiologist explained that kids really should hear at 15 decibels or better but pediatricians and schools often set their passing standards to 25 decibels. Whispering is at around 20 decibels. Once my son got ear tubes his speech and language skyrocketed. We also did the Wordly Wise program and read aloud a lot to him. He is now in 3rd grade and has a really good vocabulary. We notice that every once in a while he mispronounces a word and we think it is because he learned it when he was three and not hearing well. One ear still isn't as good as the other (pass at 25 decibels) so his audiologist wrote a note for him to be seated with better ear toward teacher and away from loud ambient noise like an air conditioning unit.
Anonymous
Post 01/01/2016 21:14     Subject: Re:Confused about expressive speech delay
Anonymous wrote:
Anonymous wrote:As an SLP, I'm a little frustrated by how unethical some SLPs in the area are, framing average scores as "low" or "borderline" to worry parents into paying a significant amount of money to fix something that isn't actually a problem. The test authors designated 85-115 as average scores. Not low average or borderline. We also collect a range of 90% probability that a child falls into which will include higher scores into the mid-90s based on an 86 which takes into account that some children don't perform their best during testing situations, or on certain days, etc. Your child received average scores on two well-respected tests, and the CELF contains a large cognitive load component which can lead to over-identifying. She will almost certainly continue being average, barring any unforeseen circumstances. Those scores are a good thing, and one or two word changes on that report would drastically impact how you felt about your daughter's future.

If you choose to give her ST, it certainly won't hurt her. She'll continue developing typically and therefore make progress. Just know that if you have better things to spend that money on, you shouldn't feel obligated. Your concern wasn't even in this area, nor were the results of the screening. ChildFind offers free screenings if you want a free second opinion, otherwise you may want to consult with another SLP in the area.

(Sorry for how negative the tone of this post is, it just frustrates me to no end. Parents worry enough about their children and those who actually need the help don't need fudging on reports to know it.)


I appreciate your thoughts and can understand your frustration. On the other hand, I'm also an educator and evaluator...I understand standard deviation and the range of 85 - 115 but think that scoring at the 16th %ile is worthy of concern. Certainly, most people would have some concerns over a WISC-V Verbal Scale Score of 85.


NP here. But, you are not a speech pathologist and you have misinterpreted the percentile. The standard scores are average. And speech therapy is not really going to change that. If this child was to be tested years later,the scores would most likely be the same. The private practice is telling the parent that this child needs speech therapy and that implies that there is a speech language delay when there really isn't. That is unethical.
Anonymous
Post 01/01/2016 21:05     Subject: Confused about expressive speech delay
You can't look at the speech test scores in isolation. You need to view them in the context of IQ scores. A kid who has a speech test score of 85 but an IQ of 120 has a greater than 2 std deviation difference. That is a concern. A kid who has an 85 speech test score and a 100 IQ score is not something to be concerned about.

Similarly, you need to compare subscores gaps of more than 1 std deviation(either 3 pts on 10+ scale or 15 on 100+ scale). So receptive scores at 120 and expressive scores of 85 are troubling.
Anonymous
Post 01/01/2016 19:15     Subject: Re:Confused about expressive speech delay
Anonymous wrote:OP here. Thanks again for the thoughtful posts and useful input. I appreciate the suggestion to follow up with an audiologist. (DD did fail the test at a lower frequency for one of her years.)


I meant "ears"
Anonymous
Post 01/01/2016 18:59     Subject: Re:Confused about expressive speech delay
OP here. Thanks again for the thoughtful posts and useful input. I appreciate the suggestion to follow up with an audiologist. (DD did fail the test at a lower frequency for one of her years.)
Anonymous
Post 01/01/2016 18:24     Subject: Re:Confused about expressive speech delay
Anonymous wrote:As an SLP, I'm a little frustrated by how unethical some SLPs in the area are, framing average scores as "low" or "borderline" to worry parents into paying a significant amount of money to fix something that isn't actually a problem. The test authors designated 85-115 as average scores. Not low average or borderline. We also collect a range of 90% probability that a child falls into which will include higher scores into the mid-90s based on an 86 which takes into account that some children don't perform their best during testing situations, or on certain days, etc. Your child received average scores on two well-respected tests, and the CELF contains a large cognitive load component which can lead to over-identifying. She will almost certainly continue being average, barring any unforeseen circumstances. Those scores are a good thing, and one or two word changes on that report would drastically impact how you felt about your daughter's future.

If you choose to give her ST, it certainly won't hurt her. She'll continue developing typically and therefore make progress. Just know that if you have better things to spend that money on, you shouldn't feel obligated. Your concern wasn't even in this area, nor were the results of the screening. ChildFind offers free screenings if you want a free second opinion, otherwise you may want to consult with another SLP in the area.

(Sorry for how negative the tone of this post is, it just frustrates me to no end. Parents worry enough about their children and those who actually need the help don't need fudging on reports to know it.)


I appreciate your thoughts and can understand your frustration. On the other hand, I'm also an educator and evaluator...I understand standard deviation and the range of 85 - 115 but think that scoring at the 16th %ile is worthy of concern. Certainly, most people would have some concerns over a WISC-V Verbal Scale Score of 85.
Anonymous
Post 01/01/2016 18:12     Subject: Confused about expressive speech delay
Oops, in the previous post I meant I would NOT pay.
Anonymous
Post 01/01/2016 18:11     Subject: Confused about expressive speech delay
Anonymous wrote:
Anonymous wrote:How old exactly was your child when administered the CELF? I think the CELF is by 6 month age ranges so one age range is 4 years, 0 months, 0 days to 4 years, 5 months, 30 days. And the next cut off is 4years 6 months, 0 days to 4 years, 11 months, and 30 days. So if your child was 4 years, 5 months I would be more concerned because many of of the normative sample were younger. If your child was 4 years 6 months I would be less concerned.


OP here: 4 years and 7 months.

I would pay for speech/language therapy. My son scored around the same at that age- not low enough to get special ed services from school district but lower than would be expected coming from two parents with high education levels. His issues stemmed from lingering fluid in his ears that required 3 sets of ear tubes. If I were you I would:
1) get your child's hearing tested by an audiologist, not just the pediatrician's office.
2) I bought and used a kindergarten vocabulary program called Wordly Wise. There are workbooks for older kids but the kinder and first grade programs have small posters, picture flash cards and a colorful workbook. You concentrate on around 10 words in a lesson. You read a story and talk about the words, your kid finds the words in the workbook and/or circles/cut and pastes. The words are taken from some of the most common elementary level books. It cost around 100 dollars for the kinder program. We did it about three times a week and it was good for me to get into the habit if emphasizing certain words. My son enjoyed the program. Here is a link to a list of words- kinder words are on the first page.
http://www.nestlearning.com/files/PDF/ww3k_word_list-level.pdf
I also like that some words had multiple meanings and the taught that "wave" could be related to the ocean or waving goodbye. Same thing with "row"- vegetables in a garden in a row or row a boat. Other words were dew, insects, tangled, destroyed, hoof, creep, cushion, brave, captured, leak, glance, and include.
Here is a link to a k sample lesson:
http://eps.schoolspecialty.com/EPS/media/Site-Resources/Downloads/samples/2818M/ww3k_bookK_unit1_lesson2.pdf?ext=.pdf
Here is a first grade one:

http://eps.schoolspecialty.com/EPS/media/Site-Resources/Downloads/samples/2818M/ww3k_book1_unit1_lesson3.pdf?ext=.pdf
Anonymous
Post 01/01/2016 15:37     Subject: Re:Confused about expressive speech delay
Anonymous wrote:OP again. Thanks for your input. The expressive language scores were 86 (on the CELF) and 90 (on the EOWPVT). For both tests, the report says that the normal range is 85 and 115.

We can afford therapy and will likely do it. But as a statistician (by training), I am really puzzled by the language in the report and what is considered a problem.


These scores are considered to be in the (low) average range. So technically she doesn't have any language issues - unless there is a language sample that shows otherwise. Therapy can't hurt but it's not a necessity. Look at the report and focus on the areas of "weakness" within the test. For example- is she having grammatical issues, does she have trouble asking for directions. While the testing doesn't show a speech language delay, the areas of weakness are something to keep an eye on in terms of academics.
Anonymous
Post 01/01/2016 15:30     Subject: Re:Confused about expressive speech delay
As an SLP, I'm a little frustrated by how unethical some SLPs in the area are, framing average scores as "low" or "borderline" to worry parents into paying a significant amount of money to fix something that isn't actually a problem. The test authors designated 85-115 as average scores. Not low average or borderline. We also collect a range of 90% probability that a child falls into which will include higher scores into the mid-90s based on an 86 which takes into account that some children don't perform their best during testing situations, or on certain days, etc. Your child received average scores on two well-respected tests, and the CELF contains a large cognitive load component which can lead to over-identifying. She will almost certainly continue being average, barring any unforeseen circumstances. Those scores are a good thing, and one or two word changes on that report would drastically impact how you felt about your daughter's future.

If you choose to give her ST, it certainly won't hurt her. She'll continue developing typically and therefore make progress. Just know that if you have better things to spend that money on, you shouldn't feel obligated. Your concern wasn't even in this area, nor were the results of the screening. ChildFind offers free screenings if you want a free second opinion, otherwise you may want to consult with another SLP in the area.

(Sorry for how negative the tone of this post is, it just frustrates me to no end. Parents worry enough about their children and those who actually need the help don't need fudging on reports to know it.)